| Carolina Neurological Consulting, Pllc | |
|
1061 X Ray Dr Gastonia NC 28054-7489 | |
| (231) 357-4220 | |
| Not Available |
| Full Name | Carolina Neurological Consulting, Pllc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 1061 X Ray Dr, Gastonia, North Carolina |
| Authorized Official Name and Position | Gary Lynn Dubisky (OWNER) |
| Authorized Official Contact | 7046714080 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Carolina Neurological Consulting, Pllc 1061 X Ray Dr Gastonia NC 28054-7489 Ph: (704) 671-4080 | Carolina Neurological Consulting, Pllc 1061 X Ray Dr Gastonia NC 28054-7489 Ph: (231) 357-4220 |
| NPI Number | 1104475219 |
|---|---|
| Provider Enumeration Date | 09/11/2019 |
| Last Update Date | 12/27/2019 |
| Certification Date | 12/27/2019 |
| Medicare PECOS PAC ID | 8325471568 |
|---|---|
| Medicare Enrollment ID | O20191202002810 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104475219 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | (* (Not Available)) | Primary |
| Provider Name | Gary Lynn Dubisky |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1144220161 PECOS PAC ID: 1557454345 Enrollment ID: I20070910001052 |
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